By Carol L. Kornmehl, M.D, FACRO
Complementary medicine integrates non-Western treatment methods into mainstream medical practice. Examples include light exercise, guided imagery, massage, yoga, reiki, tai chi, acupuncture, music therapy, and art therapy.
In the oncology area, these modalities can help to reduce side effects and thereby enhance a person’s physical and/or emotional tolerance to treatment. People thus feel better during what might otherwise be a very difficult period of cancer treatment. Fatigue is a common symptom during cancer treatment, such as chemotherapy and radiation therapy. It can stem from the underlying illness, insomnia/sleep deprivation, anxiety, and/or the cancer treatment itself. Helping people manage and reduce fatigue is an important component in enhancing their overall well-being. After all, oncologists strive to treat the whole person and not just the disease. The mechanism of fatigue in radiation therapy is not known. Often, it is not purely radiation treatment induced, but rather, is due to one or more of the factors outlined above.
In people with breast and prostate cancer, the National Cancer Institute undertook a randomized controlled study of cancer related fatigue in 38 individuals. 27 were women with breast cancer and 11 were men with prostate cancer. All received at least 30 radiation treatments, five days a week for six weeks. Baseline tests to assess fatigue, strength, and cardiovascular heath were performed before the people received radiation therapy. The study compared a half the people in the group who followed an exercise program to the half who were randomized to receive radiation therapy without exercise therapy. The program consisted of moderate, home-based use of resistance bands and walking. Of the participants in the trial, the average age was 60. Half the people received chemotherapy and 84% endured surgery. Participants were enthusiastic and 95% of them completed the prescribed exercise course.
The exercise group was required to take walks daily and to try to increase the number of steps taken each day. They wore pedometers and kept a diary. In addition, they were assigned to complete 11 resistance band exercises daily, performing one set of eight to 15 repetitions daily and gradually increasing to three to four sets. Results revealed an 82% increase in the number of steps walked daily and the use of resistance bands an average of 3 1/2 days per week for 20 minutes at a moderate intensity level. Those who exercised maintained their stamina during radiation therapy and improved their aerobic capacity. Also, they were able to walk faster and further in only four weeks and they experienced less cancer related fatigue than the control group. In fact, the control subjects demonstrated a decline in their baseline muscle strength. The mechanism by which exercise alleviates fatigue is not clear. Although this study is small and more clinical trials will be helpful, the results suggest that when exercise is non-burdensome, safe and feasible, it serves as an inexpensive, valuable tool in improving the quality of life of cancer survivors.
For more information about radiation therapy, visit www.ASTRO.org, the website of The American Society of Therapeutic Radiology and Oncology.
Copyright 2007 by Carol L. Kornmehl. All rights reserved. No part of this article may be reproduced without express written permission by the author.
Dr. Kornmehl is a board certified radiation oncologist and author of the critically acclaimed consumer health book, “The Best News About Radiation Therapy” (M. Evans, 2004). Her website is www.RTSupportDoc.com
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